How does public exposure affect recovery from a very private, traumatic experience?

The day after two Steubenville, Ohio, high school football players were found guilty in juvenile court of raping a 16-year-old girl, the victim faced a perilous new journey. Forced to confront her experience in public after photos and video of her on the night in question were circulated on social media, the 16-year-old is now being threatened by those siding with the athletes, who were part of the community’s beloved Big Red high school football team. Two girls made online threats to the victim via Twitter, menacing her with homicide and bodily harm for coming forward and launching the trial that led to the guilty verdicts for Ma’lik Richmond, 16, and Trent Mays, 17. The girls were arrested and taken to juvenile detention.

Both Mays and Richmond face at least one year in juvenile detention, with Mays potentially serving an extra year for taking and distributing images of the girl while she was naked.

But with so much attention focused on the lasting legacy the convictions will have on the boys, there seemingly hasn’t been as much concern for how the victim moves on from this very public exposure of a night she would rather put behind her. As the latest threats against her highlight, the fact that her experience unfolded in front of millions on social media may make her recovery all the more challenging. The social and emotional support that she does or does not receive now, experts say, could help determine whether she will be resilient or suffer lasting psychological damage.

“We do know that the more severe the traumatic experience is, the more severe the reaction will be,” says Edna Foa, a professor of clinical psychology in psychiatry at the University of Pennsylvania and a leading expert on trauma. Rape, regardless of the level of physical force involved, is always traumatic, although, fortunately, the vast majority of people who suffer trauma do not develop posttraumatic stress disorder (PTSD).

But in this case, the victim was betrayed by a young man she trusted. In texts sent before the girl became aware of the online photos and videos, Mays told her, “I’m going to get in trouble for something I should be getting thanked for taking care of you.” She later responded, “It’s on YouTube. I’m not stupid. Stop texting me,” the New York Timesreported.

Two of her former best friends testified for the defense in the trial, claiming that it wasn’t unusual for her to get drunk and to lie. Such betrayals worsen trauma: traumatic experiences that involve disrupted relationships tend to be the most likely to cause lasting psychological harm because they undermine trust.

In addition, social rejection and victim-blaming can potentially cancel out the resilience provided by support, according to Foa. “People saying things like ‘Get over it’ or ‘Maybe you had something to do with it’ — that we find to be a really negative predictor [of recovery],” she says.

Rape victims — and even those injured in less stigmatizing ways, such as during natural disasters or accidents — often feel shame and guilt over the experience and blame themselves for what happened. What may make recovery even more difficult for the Steubenville victim is the fact that evidence of the night’s events were widely distributed, including in a 12-minute video that mocked her inebriated and unconscious state. “We don’t have data on it, but I think it would add to severity,” says Foa. “It’s another dimension of the severity that she was so exposed.”

But there is a fine line between the harmful effects of such public exposure and the potential benefits of not having to hide or conceal emotions. When Jessica Stern, then 15, was raped at gunpoint in her home, along with her 14-year-old sister, in the late 1970s, the incident was kept quiet. Her widowed father didn’t even return home early from his business trip following the attack; the police questioned her as though she were covering up for having a secret boyfriend. And law enforcement did not inform the public; the man went on to rape least 42 other girls and women, as Stern later detailed in her book Denial.

Stern, who is now a terrorism expert and a fellow in human rights at Harvard University, developed PTSD as a result of her unresolved response to her traumatic experience. She would frequently dissociate (become entirely disconnected emotionally from her surroundings) or be hypervigilant to the tiniest hints of threat or fear. While this gave her the ability to stay calm in and survive terrifying situations, like interviewing armed Al Qaeda members in the field, “I’m not sure my response was totally healthy,” she says.

In Stern’s case, sharing her experiences rather than bottling them up could have saved her from the personal turmoil that resulted from her heightened sensitivity to threats and her tendency to distance herself emotionally in relationships.

Indeed, Amy Vorenberg, who at age 13 was raped by Stern’s attacker, had a much more open recovery experience. Her parents immediately surrounded her with support: the day after the incident, a group of her friends from the neighborhood slept over to protect her. She slept in her mother’s bedroom for years (her parents were divorced), and all her classmates and teachers were aware of what had happened so that they could be sensitive to her needs. She was “frightened but felt held,” Stern writes in her book about Vorenberg, who is now a law professor and reported a much smoother path to recovery.

“The most important thing anyone can do is to decrease the trauma survivor’s sense of shame,” says Rachel Yehuda, a professor of psychiatry at Icahn School of Medicine (formerly Mount Sinai) in New York. “Even in nonsexual traumatic events, there’s a certain sense of shame at being victimized, and that’s certainly true in the context of sexual abuse. The provision of social support is mostly to try to not judge the event or the victim’s role in the event.”

That’s the type of support Stern would like to see for the Steubenville victim. And, fortunately, the teen seems to have at least one powerful and understanding ally: her mother. Family support is especially important in overcoming trauma, and the victim’s mother has been a champion for her daughter throughout the ordeal. It was her mother who, along with other relatives, took her to the police several days after the incident and presented officers with a flash drive containing the images and social-media evidence they hoped would be enough to find and charge the perpetrators.

After the verdict, she told CNN that the result is “the start of a new beginning for my daughter.” “We need to stress the importance of helping those in need and to stand up for what is right. We hope that from this something good can arise,” she added, referring explicitly to helping others faced with the same situation. The verdict itself, as vindication of the victim’s side of the story, is a form of social support, notes Yehuda. “That might help,” she says.

Therapy can also be useful, if needed. “If after two to three weeks, she still feels as bad [as she did initially after the trauma] and you don’t see any natural recovery, that’s the time to go to treatment,” says Foa, who developed the trauma therapy known as prolonged exposure. It takes about eight to 15 sessions and involves discussing the trauma explicitly and helping victims to face situations and feelings that aren’t comfortable and that they want to avoid.

“The treatment helps you process the trauma by asking you to talk about it rather than avoid it,” says Foa, noting that many patients lives’ become so constricted by fear that they no longer go out of the house or engage in activities they used to enjoy. Another evidence-based treatment for trauma for youth is called trauma-focused cognitive behavioral therapy — and this also helps people make sense of trauma and interrupt the negative thought and behavior patterns it can produce.

Stern notes that while social media forced the Steubenville victim to face her experience even if she wasn’t ready or willing to do so, the richness of our social connections can also be turned around to help in her recovery. “I hope she will feel an army of women lifting her up,” Stern says, citing the recent cases in India and Somalia where women have begun to challenge cultures that condone rape after horrifying incidents became public. Seeing hope beyond the awful specifics of the attacks, Stern says, “I feel we’ve reached some sort of tipping point where rape victims all over the world are standing up and saying we’re not going to let ourselves be shamed into silence.”

“She had the courage — and it absolutely is courage — to come out against this violence,” says Niobe Way, a professor of psychology at NYU. “We need to be creating networks of support for her that can help her deal with this inevitable hostile response.” As Ohio Attorney General Mike DeWine said following the arrest of the two girls who threatened the Steubenville victim via Twitter after the guilty verdicts were announced: “Threatening a teenage rape victim will not be tolerated. If anyone makes a threat verbally or via the Internet, we will take it seriously, we will find you, and we will arrest you.” Those words were also a statement against a culture that minimizes or even glorifies violence against women and holds athletes to a different standard by which even criminal behavior is deemed acceptable.

It’s our ability to support rape victims and reject victim-blaming that will determine whether victims are helped or hindered in their recovery, say experts. And whether we successfully challenge cultural ideals that hold victims more responsible than the perpetrators. “We don’t want to believe we are a part of a culture that perpetuates these negative messages, but we are,” says Way.